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Tip of the Week: Before you can make improvements to your culture of safety, you first must determine where you stand. Baseline studies are among the most practical ways to gauge your culture of safety.

Accreditation Connection, May 16, 2005

The International Atomic Energy Agency defines a safety culture as an assembly of characteristics and attitudes in organizations and individuals that establishes, as an overriding priority, that safety issues receive the attention warranted by their significance.

"A 'safety culture' is the attitude that exists when everyone recognizes and accepts their responsibility for safety and when the organization 'thinks safety' as a matter of course," says James Kopf, president of operations at Healthcare Oversight in New York City.

Kopf provides these four tips to determine your baseline culture of safety:

1. Incident report analysis
Incident report analysis data is useful for medical-error reduction, especially when the organization focuses on incidents in which medical errors are determining or contributing factors. Graphic presentations of this baseline data can provide an easy comparison as you roll your safety program out and give your administrators and governing board a clear picture of your progress.

2. Litigation expenses
Litigation expenses reflect your organization's culture of safety because, more often than not, the less you are sued, the better safety culture you have. Money spent on settlements or write-offs for quality-of-care issues and legal fees provide a useful baseline for future comparisons. Regardless of your community's specific culture, your administrators and board would expect a reduction in litigation expenses as your safety culture improves.

3. Patient satisfaction surveys
The overall satisfaction of your patients can also be a telling indicator of your organization's safety. Even if your survey tool doesn't include specific questions about safety, such basic questions as, "Would you choose us again for your family's healthcare needs" and "What was your overall satisfaction with the care you received" do reflect your patients' general impressions of your facility.

4. Employee survey
Staff input is one of the best ways to determine the true culture of your organization and should be an essential component of your baseline data. As with any survey tool, careful preparation is essential to ensure that you collect useful, relevant information.

For the best survey results, Kopf suggests including the following:

    What knowledge of the present patient-safety efforts exists among the various disciplines?
    What barriers exist to creating a culture of reduced medical errors?
    What are employees' impressions of management support when errors are discovered?
    What is needed to accomplish change within your organization?
    What are employees' impressions regarding management's commitment to patient safety?
    Do people think your organization fosters a non-retaliatory environment where medical errors are concerned?
    Do they believe that your organization is truly committed to a patient safety program as opposed to creating a program to please the JCAHO?

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